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Adjuvant immunotherapy was recently approved for patients with locoregional esophageal cancer with residual disease after neoadjuvant chemoradiation. Nivo and pembro are also recommended additions to first-line chemotherapy for advanced disease based on the abstracts of CheckMate-649 and KEYNOTE-590. Here we have the full publication of KEYNOTE-590. Nearly 800 patients with advanced esophageal and Siewert I EG junction tumors were randomized to 5FU + cisplatin with or without pembrolizumab. The trial was designed to test efficacy in multiple cohorts--particularly those with squamous histology and/or a combined positive score (CPS) of 10 or more. The short answer is that the addition of pembro improved median OS across the board (9.8→ 12.4 months) and regardless of histology or PD-L1 expression. | Sun, Lancet 2021

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